论文部分内容阅读
目的探讨4D-CTA在脑动静脉畸形(CAVM)病灶检出及内部血管结构显示方面的价值。方法选取40例经DSA证实的CAVM患者的4D-CTA资料,由两位医师采用双盲法回顾性分析4D-CTA和DSA检查结果,用统一的数据表记录每个诊断项目,以DSA作为诊断金标准进行对照分析。采用SPSS 17.0统计软件进行数据处理,对4D-CTA和DSA结果进行Kappa一致性检验,评价4D-CTA检查在检测瘤巢大小、引流静脉及供血动脉方面的能力。Kappa系数<0.40表示一致性差,0.41～0.60表示一致性中等,0.61～0.80表示一致性好,>0.80表示一致性极好,P<0.05为差异有统计学意义。结果在判断CAVM病灶位置、大小及引流静脉方面,4D-CTA与DSA的符合率为100%,两种检查一致性极好(K=1,P<0.05)。在显示主要供血动脉方面,4D-CTA与DSA的符合率为95%,两种检查一致性极好(K=0.85,P<0.05)。在确定较小的动脉分支或分支细节时,4D-CTA的清晰度低于DSA。结论在检出CAVM病变,判断瘤巢位置、大小、主要供血动脉和引流静脉等方面,4D-CTA具有独特优势,在CAVM诊断中具有较高的应用价值。
Objective To investigate the value of 4D-CTA in the detection of lesions of cerebral arteriovenous malformations (CAVM) and the display of internal vascular structures. Methods 4D-CTA data of 40 DSA-confirmed patients with CAVM were selected. Two doctors used the double-blind method to analyze the results of 4D-CTA and DSA. A single data table was used to record each diagnosis item. DSA was used as a diagnosis Gold standard for comparative analysis. The data were processed by SPSS 17.0 statistical software, and the 4D-CTA and DSA results were tested for Kappa consistency to evaluate the ability of 4D-CTA to detect tumor size, drainage veins and feeding arteries. Kappa coefficient <0.40 means poor consistency, 0.41 ~ 0.60 means medium consistency, 0.61 ~ 0.80 means good consistency,> 0.80 means good consistency, P <0.05 for the difference was statistically significant. Results The coincidence rate of 4D-CTA and DSA was 100% in judging the location, size and draining veins of CAVM lesions. The consistency between the two examinations was excellent (K = 1, P <0.05). The agreement between 4D-CTA and DSA was 95%, showing excellent agreement between the two exams (K = 0.85, P <0.05) in displaying the main feeding arteries. The clarity of 4D-CTA was lower than DSA in determining smaller arterial branches or branch details. Conclusion 4D-CTA has unique advantages in detecting CAVM lesions, judging neoplasm location, size, main feeding artery and drainage veins, which has high application value in diagnosis of CAVM.